The Northwest/Alaska/Hawaii Center to Reduce Oral Health Disparities at the University of Washington in Seattle focuses on tooth decay in children, because it is the major oral health challenge U.S. society faces. Tooth decay in preschool children is worsening. The Healthy People 2010 Midcourse Review found the country moving away from national targets for young children: 22% of children 2-4 years of age have tooth decay while the target is 11%. The research plan addresses disparities and inequities in access to dental care and to healthy teeth (tooth decay or caries prevention) for low-income and vulnerable mothers and children within a conceptual framework that specifies the ecological nature of disparity problems. The specific aims of the community-based multidisciplinary research plan are to: 1) Conduct human trials to evaluate the efficacy of interventions to prevent and treat dental caries in children and their caretakers; 2) Develop community-based research that translates existing knowledge and new information into technologies and interventions that will reduce disparities; and 3) Encourage and support developmental research that has the potential to lead to independent studies to address and reduce caries inequity in children. The Center includes the Research Program Administrative Center (RPAC), two major community based intervention trials focused on dental caries- Community-Based Intergenerational Oral Health Promotion In Rural America and Parent-Child Toothbrushing with 1000 ppm Fluoride Toothpaste to Prevent ECC-and a Statistics and Data Coordinating Center (S&DCC). Primary research program sites include 12 rural county health departments in the State of Oregon serving whites and Latinos, a training center in Klamath County Oregon, and large Community Health Centers serving minority communities in Woodburn, Oregon (Salud Medical Center, Latinos) and Waianae Coast, Hawaii (Waianae Coast Comprehensive Health Center, Native Hawaiians and Pacific Islanders). Further dissemination sites are in the Alaska bush, rural Hawaii and Washington State. Developmental research projects involve communities in rural Eastern and Southwestern Washington State and focus on school nutrition and the use of topical PVP-iodine and fluoride varnish in caries prevention. The Center also includes a training core to increase the cadre of oral health disparities researchers through clinical research training and mentoring for junior scientists, efforts to enhance the awareness of health disparities research in the predoctoral curriculum in dentistry and medicine, and increases the numbers of minority and rural students entering dentistry and health sciences disciplines.